Non-Hodgkins Lymphoma Medical Diagnosis Tests

Conditions & Diseases: Cancers

Non-Hodgkin's Lymphoma

Screening, Diagnosis and Medical Tests

Physical Examination and Anamnesis
One of the first steps in the screening process is an anamnesis where past health problems are discussed, all risk factors are covered and the present health state is investigated. The doctor will try to get a detailed perspective on possible infections, health problems or lymphoma symptoms. Afterwards, the doctor will closely examine both the swollen nodes and the other lymph nodes to determine their size, location, tenderness, and consistency.

Blood and urine tests
Another step in the diagnosis procedure is blood and urine tests. When a lymphatic node swells, it is a sign that your body is fighting an infection. Therefore, the doctor will take a sample of blood and urine to establish the infection parameters and determine the causes of the infection.

X-Ray, Computer Tomography (CT) and Positron Emission Tomography (PET)
If the inflammated lymph nodes are in the chest area, they can be seen in a plain chest x-ray. If a tumor is visible on the x-ray, the doctor will follow with a CT scan in order to obtain a better image of the tumor. The CT scan is an advanced x-ray procedure that produces a more detailed cross-sectional image of the body.

The CT scan procedure involves two phases: in the first phase a first set of pictures will be taken and in the second phase, the patient will receive an intravenous injection (IV) of a radiocontrast agent in order to better outline the structure of the body and a second set of pictures will be taken.

Your doctor may also order a Positron Emission Tomography, or PET scan. This procedure is a new type of radioactive scan. A special glucose substance that contains a radioactive atom is administrated to the patient and a special camera will detect radioactivity. Lymphoma cells have a high rate of metabolism that absorbs a high amount of radioactive sugar. This procedure is effectively used in detecting non-Hodgkin’s lymphoma. It is often implemented after treatment to ascertain if any tumors remain.

Biopsies
There are several types of biopsies available in order to determine the stage of the cancer. When the doctor recommends a biopsy, the diagnosis procedure passes into the second phase of this process.

The first two steps (anamnesis, physical examination, and then x-ray, CT scan and PET scan) are decisive in establishing if there is a form of cancer or not. The role of the next procedure is to determine the cancer type, the cancer stage and other indicators necessary to establish a treatment plan.

Fine needle aspiration (FNA) biopsy. This procedure involves taking a sample of cells from the swollen lymphatic node using a thin needle attached to a syringe. When the swollen lymph node is right under the skin and palpable, the needle is then inserted directly into the node. If the lump is deep within the body, this procedure is performed with the help of a CT scan, ultrasound or other imagining techniques. This biopsy can determine noncancerous conditions from different forms of cancer and establish the cancer staging or monitor recurrence or return of cancer.
Large needle/core biopsy. This procedure involves taking a sample of tissue from the tumor. It is not a commonly diagnosed procedure and it is used just for those patients that cannot tolerate invasive surgical procedures. Like FNA, core biopsy is performed under a CT scan, ultrasound and other imagine techniques.
Surgical biopsy. There are two types of surgical biopsies: incisional biopsies, when a small piece of a large tumor is removed for examination and excisional biopsies, when the small size tumor is removed completely. Both types of surgical biopsies procedures are performed under local or total anesthesia. Biopsy procedures can be used to remove tissue from a lymph node or from the bone marrow. The lymph node biopsy provides important information about the progressive rate of the cancer.

Bone Marrow Tests
A bone marrow biopsy is necessary if there are concerns that the disease spread. The bone marrow is drawn up through a thin needle that is inserted into the pelvic bone. Once the bone marrow is extracted, it will be examined by different specialists (pathologist – the disease diagnosis specialist, hematologist – the blood specialist) and oncologist – the cancer specialist). These tests are used to establish the cancer staging.

Lumbar Puncture
A lumbar puncture or spinal tap procedure can tell doctors if the cancer has spread to the central nervous system. The puncture is made with a thin needle inserted in the lumbar backbone below the level of spinal cord and a sample of cerebrospinal fluid is withdrawn. This sample then is analyzed for the number of the lymphocytes cells.

Article by Alina Morrow, MS
Medical Writer,
OmniMedicalSearch.com